Effect of socioeconomic disadvantage on patient-reported outcomes after orthopedic trauma: a study using the area deprivation index Journal Article uri icon
Overview
abstract
  • BACKGROUND: Socioeconomic status (SES) is increasingly recognized as a key factor influencing outcomes after orthopedic procedures. The objective of this study was to determine the effect of socioeconomic disadvantage on patient-reported outcomes (PROs) after orthopedic trauma.
    MATERIALS AND METHODS: A retrospective review of PROs was performed for orthopedic trauma patients from 2018 to 2023. The Area Deprivation Index (ADI) was used as a surrogate for socioeconomic disadvantage. Outcomes included Patient-Reported Outcomes Measurement Information System Global Physical Health and Global Mental Health 10-item short forms (PROMIS 10 GPH and GMH) at 6 weeks, 3 months, 6 months, and 1 year postoperatively. A mixed-model analysis was performed to compare outcomes among ADI cohorts.
    RESULTS: In total, 844 patients were included. Of these, 313 (37.1%) were in the least socioeconomically disadvantaged group. There was a significant difference in the distributions of age, marital status, smoking status, and self-reported race among the five ADI cohorts (P < .002). Patients with an ADI of 1 or 2 (low disadvantage) had significantly higher PROMIS 10 GPH scores compared with their counterparts in ADI Groups 3/4, 5/6, and 9/10, although all groups saw a similar significant improvement from the 6-week to 1-year follow-up.
    CONCLUSION: Socioeconomic disadvantage has a significant effect on PROMIS 10 GPH and GMH scores following orthopedic trauma procedures. However, patients in all ADI cohorts saw improvements in PROMIS 10 GPH up to 1 year postoperatively. It is important to identify patients in socioeconomically disadvantaged areas and create care pathways to better optimize their improvements postoperatively.

  • Link to Article
    publication date
  • 2026
  • published in
  • Orthopedics  Journal
  • Research
    keywords
  • *Orthopedic Procedures
  • *Patient Reported Outcome Measures
  • *Social Class
  • *Wounds and Injuries/surgery
  • Adult
  • Aged
  • Female
  • Humans
  • Injuries
  • Low Socioeconomic Status
  • Male
  • Middle Aged
  • Orthopedics
  • Retrospective Studies
  • Social Determinants of Health
  • Socioeconomic Disparities in Health
  • Socioeconomic Factors
  • Surgery
  • Additional Document Info
    volume
  • 49
  • issue
  • 3